Anaphylaxis

The adverse reaction can be very fast, occurring within seconds or minutes of coming into contact with the substance the person is allergic to (allergen).

During anaphylactic shock, it may be difficult for the person to breathe, as their tongue and throat may swell, obstructing their airway.

Call 999 or 112 immediately if you think someone is experiencing anaphylactic shock.

Check if the person is carrying any medication. Some people who know they have severe allergies may carry an adrenaline self-injector, which is a type of pre-loaded syringe.

You can either help the person administer their medication or, if you're trained to do so, give it to them yourself.

After the injection, continue to look after the person until medical help arrives.

All casualties who have had an intramuscular or subcutaneous (under the skin) injection of adrenaline must be seen and medically checked by a healthcare professional as soon as possible after the injection has been given.

Make sure they're comfortable and can breathe as best they can while waiting for medical help to arrive.

If they're conscious, sitting upright is normally the best position for them.

Bleeding heavily

If someone is bleeding heavily, the main aim is to prevent further blood loss and minimise the effects of shock.

First, dial 999 and ask for an ambulance as soon as possible.

If you have disposable gloves, use them to reduce the risk of any infection being passed on.

Check that there's nothing embedded in the wound. If there is, take care not to press down on the object.

Instead, press firmly on either side of the object and build up padding around it before bandaging to avoid putting pressure on the object itself.

If nothing is embedded:

Apply and maintain pressure to the wound with your gloved hand, using a clean pad or dressing if possible. Continue to apply pressure until the bleeding stops.

Use a clean dressing to bandage the wound firmly.

If bleeding continues through the pad, apply pressure to the wound until the bleeding stops, and then apply another pad over the top and bandage it in place. Do not remove the original pad or dressing, but continue to check that the bleeding has stopped.

If a body part, such as a finger, has been severed, place it in a plastic bag or wrap it in cling film. Do not wash the severed limb.

Wrap the package in soft fabric and place in a container of crushed ice. Do not let the limb touch the ice.

Choking

Mild choking

If the airway is only partly blocked, the person will usually be able to speak, cry, cough or breathe.

In situations like this, a person will usually be able to clear the blockage themselves.

If choking is mild:

Encourage the person to cough to try to clear the blockage.

Ask them to try to spit out the object if it's in their mouth.

Do not put your fingers in their mouth if you can't see the object, as you risk pushing it further down their mouth.

If coughing doesn't work, start back blows.

Severe choking

If choking is severe, the person won't be able to speak, cry, cough or breathe, and without help they'll eventually become unconscious.

To help an adult or child over 1 year old:

Stand behind the person and slightly to one side. Support their chest with 1 hand. Lean the person forward so the object blocking their airway will come out of their mouth, rather than moving further down.

Give up to 5 sharp blows between the person's shoulder blades with the heel of your hand (the heel is between the palm of your hand and your wrist).

Check if the blockage has cleared.

If not, give up to 5 abdominal thrusts.

Do not give abdominal thrusts to babies under 1 year old or to pregnant women.

To perform abdominal thrusts on a person who is severely choking and isn't in one of the above groups:

Stand behind the person who is choking.

Place your arms around their waist and bend them well forward.

Clench 1 fist and place it just above the person's belly button.

Place your other hand on top of your fist and pull sharply inwards and upwards.

Repeat this up to 5 times.

The aim is to get the obstruction out with each chest thrust, rather than necessarily doing all 5.

If the person's airway is still blocked after trying back blows and abdominal thrusts:

Call 999 and ask for an ambulance. Tell the 999 operator that the person is choking.

Continue with the cycles of 5 back blows and 5 abdominal thrusts until help arrives.

The person choking should always be seen by a healthcare professional afterwards to check for any injuries or small pieces of the obstruction that remain.

Drowning

If someone is in difficulty in water, don't enter the water unless it's safe to do so. Don't put yourself at risk.

Once the person is on land, you need to check if they're breathing. Ask someone to call 999 for medical help.

If they're not breathing, open the airway and give 5 initial rescue breaths before starting CPR.